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"% ` CERTIFICATE OF LIABILITY INSURANCE <br />DATE (mMmo/rvyv) <br />031(1012020 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE <br />AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE <br />ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATIONIS WAIVED, <br />subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does <br />not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT NAME: <br />NABAVIAN INSURANCE AGENCY INC <br />PHONE (949)428-3321 <br />(AIC, No, Exp: <br />FAA (949)630-0274 <br />(ruc, No): <br />72186791 <br />2915 RED HILL AVE STE B201 D <br />COSTA MESA CA 92626 <br />E-MAIL ADDRESS: <br />INSURER(S) AFFORDING COVERAGE NAICS <br />INSURER A: Sentinel Insurance Company Ltd. <br />11000 <br />INSURES <br />INSURER B: <br />NOGAUS, INC <br />INSURERC: <br />4590 MACARTHUR BLVD STE 500 <br />INSURER D: <br />NEWPORT BEACH CA 92660-2028 <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: RFVISVIN NIIMRFR- <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE <br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSP <br />TYPE OF INSURANCE <br />ADDL <br />SNBOR <br />POLICYNUMBER <br />POIMMUCY EFF <br />POLICY UP <br />OMITS <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />EACH OCCURRENCE <br />$2,000,000 <br />DAMAGE TORENTED <br />PREMISES Me opowrancal <br />$1.000,000 <br />X <br />General Liability <br />$10.000 <br />MED UP (Any one person) <br />A <br />X <br />72 SBA 1B1832 <br />04/01/2020 <br />D4/01/2021 <br />PERSONALSADVINJURY <br />$2,000,000 <br />GENL AGGREGATE LIMIT APPLIES PER: <br />GENERALAGGREGATE <br />$4,000.000 <br />POLICY ❑ PRO- El LOC <br />JECT <br />PRODUCTS AGG <br />$4,000,000 <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINEDSINGLE LIMIT Ea auddentl <br />$2,000,000 <br />BODILY INJURY (Per person) <br />ANY AUTO <br />A <br />ALL OWNED SCHEDULED <br />AUTOS ALT0.S <br />'72 SBA IB1832 <br />04/01/2020 <br />D4/01/2021 <br />BODILY INJURY(Per madden U <br />X <br />MIRED NON -OWNED <br />AUTOS X AUTOS <br />PROPERTY DAMAGE <br />(Per actlOmn) <br />UMBRELLA LIAB <br />OCCUR <br />EACHOCCURRENCE <br />$1,000,000 <br />A <br />EXCESS LIAa <br />N <br />CLAIMS- <br />MADE <br />72 SBA 1B1832 <br />04/01/2020 <br />04/01/2021 <br />AGGREGATE <br />$1.000,000 <br />EDX RETENTION$ 10,000 <br />WORKERS COMPENSATION <br />PER oTH- <br />AND EMPLOYERS' LIABILITY <br />STATUTE <br />E.L. EACH ACCIDENT <br />ANY YIN <br />PROPRIETOR,PARTNER/EXECUTIVE <br />OFFICERA EMBER EXCLUDEDY <br />W A <br />EL DISEASE -EA EMPLOYEE <br />(Mandatary In NH) <br />If yes, describe under <br />E.L.DISEASE - POLICY OMIT <br />DESCRIPTIO OF OPERATIONname <br />I <br />A <br />FAILSAFE TECHNOLOGY E OR <br />O <br />72 SBA IBIS32 <br />04/01/2020 <br />04/01/2021 <br />Each Glitch <br />Aggregate <br />$1,000,000 <br />$1.000,000 <br />DESCRIPTION OF OPERATIONS/LOCATIONS/ VEHICLES (ACORD 101, AddlHenal Remarks Schedule, maybe attached If mare apace Is required) <br />Those usual to the Insured's Operations. City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured and <br />Coverage is primary and noncontributory per the Business Liability Coverage Form SS0008, attached to this policy. Notice of Cancellation will be <br />provided in accordance with Form SS1223, attached to this policy. <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Ana <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />Risk Management Division <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED <br />20 CIVIC CENTER PLZ FL 4 <br />IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />SANTA ANA CA 92701-4058 <br />ED <br />d Uen" x Cam, <br />R EMT D CORD 25 (201611$j' RjSk MANACii h -ACORD name and logo are registered maCORPORATION. All rights reserved. <br />marks of A ORD A <br />AY 1 a2a <br />